My wife has been ill for some time now and our family doctor has not found out what is wrong. Our doctor sent us to a rumatoid arthritis doctor and that is when we found out she tested positive for the human parvo virus. My wife was on your site last night so you may be answering our question twice but I am very concerned what type of doctor do we need?

Response from Dr. Frascino

Hello,

The rheumatologist may be willing to treat parvovirus infection and its complications. If not, a hematologist should be consulted. You can read about parvovirus and its treatment (intravenous gamma globulin) in the archives. A sample question from the archives is posted below.

Good luck to you and your wife.

Dr. Bob

Parvo Virus b19
Mar 3, 2004

I was really sick for a week and a half and have been having really bad joint pains. So bad I can hardly walk. My doctor gave me Ibuprofen and tylenol with codene. It helps a bit , but when it wears off in the middle of the night I can hardly get up to take more. After numerous blood tests they have founds the parvo virus. I was thinking it was Lupus. All of the symtems are like lupus. Are the symptoms very much a like? How long will this joint pain last for? Is it very dangerous for someone who is HIV +? Should I be in so much pain?

Response from Dr. Frascino

Hello,

Infection with Parvovirus B19 is common. Approximately 60% of adults worldwide have B19-specific antibody, indicating previous exposure to the virus.

In folks with normal immune systems, Parvovirus B19 can cause a rash (Erythema Infectiosum, "slapped cheek rash") and fever. This is also called "fifth disease," and is frequently seen in kids.

In children, Parvovirus B19 is usually mild and of short duration. However, in adults, and especially in women, symmetrical painful joints can develop in 50% of those infected. The small joints of the hands and feet are primarily involved, and swelling and stiffness can often occur. Joint symptoms usually last 1-3 weeks, although in about 20% of affected women, the joint symptoms may persist or recur for more than two months, and in some cases, even up to two years. The joint pain usually responds to nonsteroidal/anti-inflammatory medication. If your pain control is not sufficient, talk to your doctor. An alternate, longer acting pain medication may be needed for a while.

Some symptoms may seem like lupus, but in the absence of a history of rash, the symptoms are most often mistaken for acute rheumatoid arthritis, especially because Parvovirus B19 can be associated with a transiently positive blood test called "rheumatoid factor" that is seen in rheumatoid arthritis.

Parvovirus B19 can be an opportunistic infection in folks with immune deficiency, such as AIDS. The important information for HIV-positive folks to know is that if our immune systems are impaired or deficient, we may not be able to fight off a routine parvovirus B19 infection. So, instead of a self-limited relatively mild condition, if we lack the appropriate immune system defenses and response, we could develop a persistent parvovirus B19 infection. This can lead to a condition called red-cell aplasia with severe anemia. Diagnosis of parvovirus B19 is made with a blood test. It is most effectively treated with IVIG (intravenous immunoglobulin), which has a good source of neutralizing antibodies. Relapses in patients with AIDS or other conditions associated with severe immunodeficiency are common, but respond to repeated doses of IVIG. Hope that helps. Dr. Bob

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